ABSTRACTS.

New York's Killed by Traffic.

In New York city, during 1911, 423 persons were killed and 2,004 injured by traffic-For 1910 the figures were: 376 and 930. Contrary to popular belief, automobiles do not kill as many persons as wagons-142 against 172. Nearly half-sixty -automobile homicides were attended with escape of the chauffer. In this connection it may be noted that for several years the number of persons killed in and by automobiles is approximately equal to the number killed by railroads and trolleys, for the whole country.

Untoward Effects of Salvarsan.

Gonder (Roussky Uratch), working in Ehrlich's laboratory, determined by a series of experiments on mice that the addition of even minute traces of calcium salts to salvarsan increased the toxicity of the latter. Thus, when the syringe is boiled in tap water which contains calcium, the traces of lime adhering to the syringe are sufficient to affect the toxicity of salvarsan. When brought in contact with an alkaline medium, as happens when injected into the circulation, the calcium is thrown out of solution, and is found on autopsy to have caused embolism. This toxic effect of calcium, however, may be prevented by the addition of a small quantity of sodium citrate, which keeps the lime in solution. The salts of magnesia exert a similar action.

Controlling the Administration of Serum in Epidemic

Meningitis.

Sophian, in the operation of administering serum, employs an assistant to take blood pressure readings throughout the whole operation. If the blood pressure drops ten mm. during the removal of cerebrospinal fluid it indicates that the withdrawal must cease. In a similar manner a drop of twenty mm. in an adult is a safe indication to stop the further injection of serum. He concludes his paper by saying that the old method of administering serum is inaccurate and someimes dangerous. The change in blood pressure determines accurately the quantity of serum that can be safely injected, and indicates also the quantity of cerebrospinal fluid that can be withdrawn. By the blood pressure method the dose is smaller and the after effects are much less severe.

Can Salvarsan Take the Place of Mercury?

This question heads an article by Dreuw (abst., in Fortschritte der Medizin, March 7th, 1912, 317), a police surgeon in Berlin. As the result of much experience in the inspection and regulation of the demi-monde, he believes that for the great majority of cass, mercury in some form should be the sheet-anchor; salvarsan being reserved for the cases where mercury can not be given or when it fails. He lays down the following principles: 1. Salvarsan should not be given by intra-muscular or sub-cutaneous injection. 2. The combined treatment, with salvarsan and mercury, obscures the course of the disease and renders difficult an accurate opinion of the value of the salvarsan. 3. Salvarsan is of no advantage in the treatment of prostitutes; on the contrary, its use is dangerous, as it only smothers the symptoms temporarily, and is by no means as ef fective as mercury. 4. The relapses that follow the salvarsan treatment are somewhat characteristic and are in many cases more violent than under the ordinary treatment.

GIFFORD (Omaha).

Normal Human Blood-Serum in Melena Neonatorum and Other Conditions.

(J. E. Welch, New York. The Therapeutic Gazette, February 15, 1912.)

Drawing his conclusions from a series of thirty-two cases of hemorrhagic disease treated by means of injections of human blood-serum, Welch calls attention to the remarkable therapeutic effect obtained. Not only in melena neonatorum, but also in hemophilia, uncontrollable epistaxis, and in septic peritonitis have splendid results been obtained. He emphasizes the dangers attending the use of alien sera and contrasts these with the harmlessness of the injections of homologous, i. e., human serum. Large quantities of serum are used-for instance, in a case of hemophilia in a five-year-old child 1034 cc. were administered hypodermatically in the course of five days. In a new born child weighing 5 pounds 12 ounces, 630 cc. of serum were given in the course of seven days, the case going on to recovery, although at the outset the prognosis appeared practically hopeless.

Welch believes that the rapid cessation of the bleeding after administration of the serum is due to the effect of the serum on the endothelial cells lining the blood vessels.

Quick Macroscopic Agglutination Test.

Ruhrah (Archives of Pediatrics) describes the Bass-Watkins agglutination test of typhoid, because he thinks it has not attracted the attention which it merits. A suspension of dead typhoid bacilli is used in the strength of 10,000 million bacilli in each c.c. in 1.7 per cent sodium chloride solution, to which is added one per cent liquor formaldehydi. It is stable. Onequarter of a drop of blood is placed upon a glass slide, diluated with one drop of water, and thoroughly mixed. One drop of the test fluid is then added to it and the mixture agitated for onehalf to two minutes by tilting the slide from side to side. If the reaction is positive a grayish mealy sediment appears within one minute, giving a granulated appearance easily seen with the unaided eye. This consists of agglutinating bacilli. The specimen may be examined at the bedside or at some later time. It gives trustworthy results in infants and children, all cases of typhoid having been positive and all other diseases negative.

The Pulmotor-A New Apparatus for Resuscitating the Drowned and Asphyxiated.

So much interest has been aroused by the press accounts of this new apparatus for performing artificial respiration and forcing a supply of oxygen into the lungs that we are glad to publish the following description from the American Jour. of Clin. Med. (April, 1912).

The pulmotor which the Commonwealth Edison Company has so far sent out is about the size of a large suit case. In the lower portion of the case is an iron cylinder, three and one-half by twenty-one inches, containing oxygen at a pressure of about 2800 pounds when completely filled. This life-sustaining gas also furnishes the energy which is required to induce breathing, in the following manner:

The oxygen from the tank flows through a reducing valve, which at the outlet side maintains a pressure of about seventyfive pounds, and from there to the controlling valve. Initially the passage to the lungs is open through this controlling valve. The latter connects with rubber tubes leading to a metallic facecap with a rubber rim which closely fits the patient's face. This face cap on one side is provided with a rubber bag, which permits a pair of forceps to protrude, by means of which the patient's tongue is held from obstructing the pharynx. The oxygen then has free access to the lungs.

When the pressure in the lungs has reached a certain value (about normal), a bellows interconnected with the lung cavity through the rubber tubes actuates the controlling valve. The pressure of the oxygen is now directed so as to create a suction over the connections which lead to the lungs, thereby causing exhalation of the gases previously forced into the lungs. When a certain vacuum is reached in the lungs and bellows, the outer atmosphere acts on the latter, which in turn operates the controlling valve and again admits the oxygen to the lungs. The frequency of these reversals depends upon the size of the lung cavity, a larger space requiring greater time, while with smaller lung cavities the operation is correspondingly more frequent.

This process is continued until the patient shows signs of natural respiration. The pulmotor action is then discontinued and the patient is allowed to breathe the pure oxygen through another small face cap connected by a hose directly with the oxygen tank. ·

Several patients can be treated at once. An extra tank of oxygen is carried in nearly all calls. This enables the operator to treat two persons at the same time, using the pulmotor on one and giving the other person oxygen from the oxygen bag. The majority of calls have been for more than one person-in several cases for four persons. In the latter cases it was possible to treat them all at practically the same time by having the patients close together and transferring the pulmotor and oxygen tube from one to the other.

An Insane Classic.

A penniless lawyer of Chicago hopelessly insane, who was an inmate of the hospital at Dunning, died a few years since, leaving nothing but the following prose poem, in the form of a will. It will outlive many a learned treatise destitute of imagination, fancy or sentiment; and even many a bit of verse illuminated by the glow of true poetic feeling. Incidentally it illustrates the kinship which often subsists between talent and mental observation, and may serve and correct current misconceptions with reference to the natrue of insanity.

I, Charles Lounsberry, being of sound and disposing mind and memory, do hereby make and publish this, my last will and testament, in order, as justly may be, to distribute my interest in the world among succeeding men.

That part of my interest, which is known in law and recognized in the sheep bound volumes as my property, being incon

siderable and of none account, I make no disposition of in this, my will. My right to live, being but a life estate, is not at my disposal, but these things excepted, all else in the world I now proceed to devise and bequeath.

Item: I give to good fathers and mothers in trust for their children, all good little words of praise and encouragement, and all quaint pet names and endearments, and I charge said parents to use them justly, but generously, as the needs of their children shall require.

Item: I leave to children exclusively, but only for the term of their childhood, all and every, the flowers of the fields, and the blossoms of the woods, with the right to play among them freely according to the customs of children, warning them at the same time against thistles and thorne. And I devise to children the banks of the brooks and the golden sands beneath the waters thereof, and the odors of the willows that dip therein and the white clouds that float high over the giant trees. And I leave to children the long, long days to be merry in, in a thousand ways, and the night, and the moon, and the train of the milky way to wonder at, but subject, nevertheless, to the rights hereinafter given to lovers.

Item: I devise to boys jointly, all the useful, idle fields and commons, where ball may be played; all pleasant waters where one may swim; all snowclad hills where one may coast; and all streams and ponds where one may fish, or where, when grim winter comes, one may skate, to have and to hold these same for the period of their boyhood. And all meadows, with the clover blossoms and butterflies thereof; the woods with their appurtenances, the squirrels and birds and echoes and strange noises, and all distant places which may be visited, together with the adventures there found. And I give to said boys each his own place at the fireside at night, with all the pictures that may be seen in the burning wood, to enjoy without let or hindrance, and without any incumbrance of care.

Item: To lovers, I devise their imaginary world with whatever they may need, as the stars of the sky, the red roses by the wall, the bloom of the hawthorne, the sweet strains of music, and aught else they may desire to figure to each other the lastingness and beauty of their love.

Item: To young men, jointly, I devise and bequeath all boisterous, inspiring sports of rivalry, and I give to them the disdain of weakness and undaunted confidence in their own strength. Though they are rude, I leave to them the power to